=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104741222
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EVERLIN FERNANDEZ NP IN PSYCIATRY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/10/2026
-----------------------------------------------------
Last Update Date | 08/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 169 MADISON AVE STE 15265
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-5101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-625-5395
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 169 MADISON AVE STE 15265
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-5101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-625-5395
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHIATRIST
-----------------------------------------------------
Name | DR. EVERLIN ELIZABETH FERNANDEZ
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 646-836-3046
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------